Distress Brief Intervention pilot programme: evaluation

14 Appendix B – Outcome Measures

The following outcome measures were used in routine DBI data collection and evaluation surveys:

Distress Thermometer (Mitchell 2007)

DBI practitioners used the Distress Thermometer at three time points: at Level 1, and at the start and end of the Level 2 intervention. This used a simple 10 point score where 0 = no distress and 10 = extreme distress reported by the individual to the practitioner as to their perceived level of distress.

CORE-OM 5 (Evans et al. 2002)

CORE-OM 5 is a five-item measure of psychological distress adapted from the validated CORE-OM 34-item full measure, which was designed for use in tracking recovery and improvement. It is intended to give an indication of psychological distress level and any change in distress which can be measured over the course of the intervention. It was selected in consultation with DBI programme practitioners due to its length and ease of use. It builds up a broader picture of psychological distress than the Distress Thermometer.

The CORE-OM 5 question scale was self-completed by individuals in the first and final Level 2 session evaluation surveys. Each response to CORE-OM 5 is assigned a score, the average score is calculated and then multiplied by 10 to give the final score. A score of less than 10 indicates very low distress (a distress level lower than that of a typical 'clinical' population after therapy) and a score of 10 or greater, up to a maximum of 40, indicates psychological distress. A score of more than 25 indicates severe distress, a score of between 20 and 25 indicates moderate to severe distress, and a score of 15 to 19.9 indicates moderate distress.

Consultation and Relational Empathy Measure (CARE) (Mercer et al. 2004)

The Consultation and Relational Empathy (CARE) Measure (Mercer et al. 2004) is a person-centred process measure that was developed and researched at the Departments of General Practice at the University of Glasgow and University of Edinburgh. The CARE Measure is a quick, clear and easy to complete questionnaire. It measures empathy in the context of the therapeutic relationship during a one-on-one consultation between a practitioner and an individual.

For this evaluation, we used an adapted version of the original measure. To ensure consistency of rating scales in the surveys for individuals accessing DBI, the scale used for this evaluation was changed from the original 'How was the doctor at..', (with each item rated either poor, fair, good, very good, excellent or does not apply), to 'Please read each statement and indicate how much you agree or disagree with it…', (with each item rated either strongly agree, agree, neither agree nor disagree, disagree, strongly disagree). This measure was embedded in the Level 2 final session questionnaire, which was delivered at the final Level 2 support session. The ten measure items were each scored 1 (strongly agree) to 5 (strongly disagree). Adding the scores for each item together gives a scale of 10 (strongly agree) to 50 (strongly disagree). We used three analysis categories: 1) a score of 10; 2) a score of 11 to 20 (which represents an average of 1.1 to 2, or at least agreeing to all the items); and 3) a score of 21 or more.